Number 4

ABSTRACT Zhang B, Yi H, Jiang Y, Zheng C. A comparison of the treatment outcomes of cerebral gas embolism at 2.8 ATA in comparison with 6 ATA. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):341-346. Objective: To investigate the effect of 6 ATA air/ oxygen treatment scheme and 2.8 ATA oxygen inhalation scheme on cerebral gas embolism. Methods: 29 patients with cerebral gas embolism admitted from January 2014 to June 2022 were retrospectively included. The patients were divided into 6 ATA air/ oxygen treatment scheme group (14 cases) and 2.8 ATA oxygen inhalation therapy scheme group (15 cases). Glasgow Coma Scale (GCS) was used to evaluate the therapeutic effect before and after treatment. The effective standard of treatment: recovery of consciousness (GCS scores>8). Results: There was no significant difference between two groups in terms of gender, age, cause of disease, time of onset and GCS score before treatment (P>0.05). There was not significant difference between two groups in terms of GCS score after 1 day and 1 week of treatment (P>0.05). After 1 week of treatment, 78.6% (11/14) of patients in the 6 ATA group and 80.0% (12/15) in the 2.8 ATA group improved. Conclusion: The 2.8 ATA oxygen inhalation scheme can effectively treat cerebral gas embolism, and effect ..

ABSTRACT Ting-Ting Z, Zhen-Biao G, Jia-Jun X, Shi-Feng W, Wen-Wu L. Influence of hyperbaric air exposure on the function of brachial artery. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):347-351. Decompression after diving may inevitably cause the production of bubbles in the body, even without protocol violation. Bubbles produced in the circulation may damage the vascular cells, leading to vascular dysfunction. In this study, five subjects were recruited and subjected to hyperbaric exposure (15 meters; 100 minutes). The function of the brachial artery was assessed by measuring diameter, systolic peak velocity (SPV), resistance index (RI), and flow-mediated dilation (FMD) of the brachial artery before and after hyperbaric exposure. Our results showed that hyperbaric air exposure slightly increased the diameter of the brachial artery and significantly increased its RI but reduced the FMD and markedly decreased the SPV. This study indicates that hyperbaric air exposure at low pressure may also alter the function of the brachial artery. Keywords: brachial artery, diving, flow-mediated dilation, ultrasound, vascular endothelium   DOI: 10.22462/682

Inal A, Hallak M, Baktir MA, Ekebaş G, Atasever A. Investigation Of The Effects Of Hyperbaric Oxygen Therapy On Hepatotoxicity Induced By Leflunomide in Rats. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):353-359. Background: Hyperbaric Oxygen Therapy (HBO2) is a treatment modality that exposes patients to 100% oxygen at higher atmospheric pressures. Recently, HBO2 has emerged as a potential therapeutic option for various liver diseases, offering advantages such as improved tissue oxygenation, anti-inflammatory effects, enhanced wound healing, and potential hepatoprotective properties. Understanding the benefits of HBO2 in liver diseases can pave the way for novel therapeutic strategies and improved patient outcomes. This study aimed to investigate the hepatoprotective effect of HBO2 in arthritic rats treated with leflunomide (LEF) through anti-inflammatory and antioxidant pathways. Material and Methods: 24 male Sprague-Dawley rats were divided into three groups (8 animals in each group (n = 8)). 1st group was the control group, which received no treatment. 2nd group was RA + LEF5 mg/kg, 3rd group was RA + LEF 5 mg/kg + HBO2. Rheumatoid arthritis was induced using Complete Freund's Adjuvant (CFA). The treatment was initiated on the 10th day following induction and lasted fora total of 18 days. The impact on disease progression was assessed through histological changes, which were evaluated using hematoxylin-eosin ..

Antunes BN, Müller DCM, Milech V, Caye P, Degregori E, Vargas D, Reinstein RS, Brun MV. Behavior and changes in rectal temperature in dogs and cats undergoing hyperbaric oxygen therapy: clinical data review. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):361-367. The assessment of rectal temperature and behavior is an important parameter in all patients for whom hyperbaric oxygen (HBO2) therapy is used. The study aims to verify if there is less reduction in body temperature after HBO2 therapy in restless patients and their behavior during the therapeutic session. Clinical data from 217 HBO2 therapy sessions with 2 to 2,5 atmospheres absolute (ATA) were reviewed under therapy protocols of 30 (P1) or 45 (P2) minutes, covering 29 canines and 13 felines. Behavioral data, initial rectal temperature (iRT), final (fRT), and variation between them (RTv) of each patient were recorded. Parameters of oxygen concentration, humidity, temperature, and chamber flow rate were also recorded. Three of 217 patients experienced major adverse effects (seizure and auto-trauma). 144/217 HBO2 therapy session records were selected for statistical analysis. In P1 sessions, 33.3% of the canine and 33.3% of the feline patients were restless. In P2 sessions, 40.7% of the canine and 28.1% of the feline patients were restless. The ..

Laspro M, Wei LW, Brydges HT, Gorenstein SA, Huang ET, Chiu ES. Hyperbaric Oxygen Therapy Regimens, Treated Conditions, and Adverse Effect Profile: an Undersea and Hyperbaric Medical Society Survey Study. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):369-376. Introduction: When administering HBO2, pressures can range from 1.4 atmospheres absolute (ATA) to 3 ATA. While different treatment profiles have been proposed, there is a paucity of literature comparing the effectiveness and risk profile associated with different pressures treating the same condition. Considering the therapeutic divergence, this study aims to survey Undersea and Hyperbaric Medical Society (UHMS) members on pressure modalities and their use in different clinical conditions. Methods: The study was a voluntary cross-sectional survey administered online and open to healthcare providers who were Undersea and Hyperbaric Medical Society members. UHMS itself distributed the survey link. The survey period lasted from November 2022 until January 2023. Data were collected utilizing the Qualtrics platform and analyzed through Microsoft Excel. Results: A total of 265 responses were recorded. The majority responded with utilizing 2.4 ATA (35.2%) as the pressure of choice, followed by 2.0 ATA only (27.1%), and those who utilized differing therapeutic pressures (26.4%). The overwhelming choice for treatment of osteoradionecrosis (ORN) of the jaw, radiation proctitis/cystitis, diabetic ..

ABSTRACT Mátity L, Burman F, Cronje F. Optimizing the hyperbaric chamber pressurization profile during standard hyperbaric oxygen therapy. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):377-385. Middle ear barotrauma (MEBT) is the most common complication in providing hyperbaric oxygen therapy (HBO2). This study explored the impact of altering the shape of the time-pressure curve with the aim of reducing the occurrence of MEBT and optimizing the HBO2 experience during the pressurization process. Four distinct mathematically derived protocols—Constant Pressure Difference (CPD), Constant Volume Difference (CVD), Constant Ratio (CR), and Inverted Constant Ratio (ICR)—were investigated using computer simulations on a simple ear model. Results indicated varying levels of ear strain during pressurization. The CR pressurization demonstrated balanced ear strain levels and outperformed other modalities in several measures, including the impact on the simulated ear cavity volume. The potential for enhanced patient comfort through the application of sophisticated pressurization protocols warrants further research to validate and extend the findings of this study in real-world HBO2 settings. Keywords: barotrauma; compression; constant ratio; descent; middle ear; pressure DOI: 10.22462/715

Demir L. Does hyperbaric chamber attendance pose an asthma risk? Case report. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):387-391. This report details a case study of a non-smoking 33-year-old female nurse who developed occupational asthma as an Inside Attendant (IA) in a hyperbaric chamber. The report analyzes the nurse's medical history, working environment, and potential causes. After beginning work in the hyperbaric chamber,an IA experienced respiratory symptoms, including coughing, wheezing, and fatigue. Her symptoms improved during a break attending a hyperbaric nursing certification program but returned when she resumed work in the IA hyperbaric chamber. Spirometry confirmed airflow obstruction, and the IA was subsequently diagnosed with occupational asthma. As a result, the IA had to terminate their employment in the hyperbaric chamber. The literature review indicates that diving and hyperbaric exposure can negatively affect respiratory function, particularly in individuals susceptible to respiratory issues. We emphasize the necessity for further research on the effects of hyperbaric exposure on the respiratory system of IAs. Keywords: hyperbaric oxygen therapy; inside attendant; lung function; occupational asthma DOI: 10.22462/727

Leder Macek AJ, Wang RS, Cottrell J, Kay-Rivest E, McMenomey SO, Roland Jr. T, Ross FL. Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss – A Comorbidity Lens. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):393-402. Objective: To determine the outcomes of patients receiving hyperbaric oxygen therapy for sudden sensorineural hearing loss and the impact of patient comorbidities on outcomes. Study Design: Retrospective chart review. Setting: Tertiary referral center. Methods: All patients over 18 diagnosed with sudden sensorineural hearing loss between 2018 and 2021 who were treated with hyperbaric oxygen therapy were included. Demographic information, treatment regimens and duration, and audiometric and speech perception outcomes were recorded and analyzed. Results: 19 patients were included. The median age was 45 years. 53% were female and 21% had pre- existing rheumatologic disorders. The mean duration between hearing loss onset and physician visits was 9.6 days. All patients received an oral steroid course, while 95% also received a median of 3 intratympanic steroid injections. Patients began hyperbaric oxygen therapy an average of 34.2 days after the hearing loss onset for an average of 13 sessions. No significant relationships were found between patient comorbidities and outcomes. Of those who reported clinical improvement, 57% demonstrated complete recovery per Siegel’s criteria. There was significant improvement after ..

Johnson-Arbor K. Hyperbaric oxygen therapy for treatment of vascular occlusion after permanent dermal filler injection. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):403-406. Introduction: Arterial vascular occlusion is a rare complication of dermal filler injection. This case report describes the successful use of hyperbaric oxygen therapy in a patient with vascular occlusion after a permanent dermal filler was injected. Case Report: A 51-year-old woman underwent an injection of non-resorbable polymethylmethacrylate microspheres into her nasolabial folds. Several hours later, she experienced dusky discoloration of the right nasolabial fold and surrounding livedo skin changes, consistent with vascular occlusion. Treatment with warm compresses and topical nitroglycerin was initiated, and the patient was referred for hyperbaric oxygen therapy. The tissue discoloration improved significantly after the administration of six hyperbaric treatments. Discussion: While hyaluronidase is recognized as a treatment option for vascular occlusion associated with using temporary fillers containing hyaluronic acid, it may also be beneficial for patients who experience vascular occlusion after administration of permanent fillers. Hyperbaric oxygen therapy, which results in hyperoxygenation of ischemic tissue and mitigation of the associated inflammatory response, may also benefit patients who experience vascular occlusion after permanent filler injection. Conclusions: Administration of hyaluronidase and hyperbaric oxygenation should be considered for patients who develop arterial occlusions after ..

Risberg J, van Ooij PJ, Mátity L. Recovery from pulmonary oxygen toxicity: a new (ESOT) model. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):407-423. Arieli has previously demonstrated that the exposure metric K could be used to predict pulmonary oxygen toxicity (POT) based on changes in Vital Capacity (VC). Our previous findings indicate that the Equivalent Surface Oxygen Time (ESOT) allows the estimation of POT without loss of accuracy compared to K. In this work, we have further investigated POT recovery. The K metric assumes that the recovery of POT is to be controlled by exposure to pO2. This results in a counterintuitively slow estimated recovery after exposure to low pO2. Similarly, K overestimates POT during intermittent hyperoxic exposures. We used results from previous studies to train the parameters of a new ESOT recovery model. The predicted recovery of ESOT (ESOTrec) after initial hyperoxic exposure (ESOTi) of duration texp (h) and recovery time t (h) can be calculated as ESOTrec=ESOTi · e-f with f=0.439 · t · 0.906texp. For intermittent exposures, the function ESOT(n)=(n · a · ln(b · n+1)+c) · texp · pO22.285 will approximate POT (ESOT(n)) after n sessions of pO2 (atm) for time texp (min) in each cycle. Parameters a, b, and c are specific for each ..

LeGros TL, Murphy-Lavoie H. Hyperbaric Treatment of Air or Gas Embolism: Current Recommendations. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):425-448. Sudden sensorineural hearing loss (SSNHL) presents as the abrupt onset of hearing loss. Approximately 88% of SSNHL has no identifiable etiology and is termed idiopathic sudden sensorineural hearing loss (ISSHL) [1]. Hearing specialists have investigated ISSHL since the 1970s. Over the past 30 years, morethan 800 articles, or one every two weeks, have been published in the English medical literature [2]. ISSHL is the abrupt onset of hearing loss, usually unilaterally and upon wakening, that involves a hearing loss of at least 30 decibels (dB) occurring within three days over at least three contiguous frequencies [3-4]. As most patients do not present with premorbid audiograms, the degree of hearing loss is usually defined by the presentation thresholds of the unaffected ear [4]. Other associated symptoms include tinnitus, aural fullness, dizziness and vertigo [4-5]. The historical incidence of ISSHL ranges from 5–20 cases/100,000 population, with approximately 4,000 new cases per annum in the United States [4,6]. The true incidence is thought to be higher, as ISSHL is thought to be underreported. Interestingly, 4,000 cases annually calculate to 1.3 cases/ 100,000 in ..

Tomoye EO, Park CL, Folke L, Moon RE. Intracranial Abscess. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):449-455. The term “intracranial abscess” (ICA) includes cerebral abscess, subdural empyema, and epidural empyema, which share many diagnostic and therapeutic similarities and, frequently, very similar etiologies. Infection may occur and spread from a contiguous infection such as sinusitis, otitis, mastoiditis, or dental infection; hematogenous seeding; or cranial trauma [1]. Brain abscess usually results from predisposing factors such as HIV infection, immunosuppressive drug treatment, surgery, adjacent infection (i.e., mastoiditis, sinusitis, dental infection), or systemic infection causing bacteremia [1]. Approximately 30% to 50% of infections are caused by contiguous spread of local infections. Hematogenous spread is responsible in around a third of cases, with the mechanism for the remainder not identifiable [1-4].